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518 results on '"Decker, Roy H."'

1. Hazardous Attitudes: Physician Decision Making in Radiation Oncology

Author

Saeed, Nadia A, Blakaj, Adriana, Kelly, Jacqueline R, Decker, Roy H, Ford, Eric C, Brown, Derek W, Dosoretz, Arie P, and Evans, Suzanne B

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Cancer, Prevention, Oncology and carcinogenesis
Abstract

PurposeThe Federal Aviation Administration quantifies hazardous attitudes (HAs) among pilots using a scale. HAs have been linked to aviation risk. We assessed the influence of HAs and other factors in treatment decision making in radiation oncology (RO).Methods and materialsAn anonymous survey was sent to 809 radiation oncologists in US cities housing the top 25 cancer centers. The survey included an HA scale adapted for RO and presented 9 cases assessing risk-tolerant radiation therapy prescribing habits and compliance with the American Society for Radiation Oncology's Choosing Wisely recommendations. Demographic and treatment decision data were dichotomized to identify factors associated with prescribing habits using univariable and multivariable (MVA) logistic regression analyses.ResultsA total of 139 responses (17.1%) were received, and 103 were eligible for analysis. Among respondents, 40% were female, ages were evenly distributed, and 83% were in academics. Median scores for all attitudes (macho, anti-authority, worry, resignation, and impulsivity) were below the aviation thresholds for hazard and data from surgical specialties. On MVA, responders >50 years old with >5 years' experience were 4.45 times more likely to recommend risk-tolerant radiation (P = .016). Macho attitude was negatively associated with Choosing Wisely compliant treatments (odds ratio [OR], 0.12; P = .001). Physicians who reported having previously retreated the supraclavicular fossa without complication were more likely to recommend retreatment in medically unfit patients if they felt the complication was avoided owing to careful planning (OR, 5.2; P = .008).ConclusionsTo our knowledge, this represents the first study analyzing physician attitudes in RO and their effect on self-reported treatment decisions. This work suggests that attitude may be among the factors that influence risk-tolerant prescribing practices and compliance with Choosing Wisely recommendations.

Published
2022

2. A Dose-finding Study Followed by a Phase II Randomized, Placebo-controlled Trial of Chemoradiotherapy With or Without Veliparib in Stage III Non–small-cell Lung Cancer: SWOG 1206 (8811)

Author

Argiris, Athanassios, Miao, Jieling, Cristea, Mihaela C, Chen, Allen M, Sands, Jacob M, Decker, Roy H, Gettinger, Scott N, Daly, Megan E, Faller, Bryan A, Albain, Kathy S, Yanagihara, Ronald H, Garland, Linda L, Byers, Lauren A, Wang, Ding, Koczywas, Marianna, Redman, Mary W, Kelly, Karen, and Gandara, David R

Subjects
Lung, Lung Cancer, Clinical Trials and Supportive Activities, Clinical Research, Cancer, Rare Diseases, Orphan Drug, 6.1 Pharmaceuticals, 6.5 Radiotherapy and other non-invasive therapies, Evaluation of treatments and therapeutic interventions, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Benzimidazoles, Carboplatin, Carcinoma, Non-Small-Cell Lung, Chemoradiotherapy, Dose-Response Relationship, Drug, Female, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasm Staging, Paclitaxel, Progression-Free Survival, Survival Rate, NSCLC, Thoracic radiotherapy, PARP inhibitors, carboplatin, paclitaxel, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

BackgroundWe conducted a 2-part study to evaluate the incorporation of veliparib, a PARP inhibitor, into chemoradiotherapy (CRT) for stage III non-small-cell lung cancer.Patients and methodsIn the phase I part, patients were treated successively at 3 dose levels of veliparib (40, 80, and 120 mg) twice daily during CRT. In the phase II part, patients were randomized to receive veliparib or placebo during thoracic radiotherapy with concurrent weekly carboplatin and paclitaxel, followed by 2 cycles of consolidation carboplatin and paclitaxel with veliparib or placebo. The study was prematurely discontinued owing to the emergence of adjuvant immunotherapy as standard of care.ResultsOf 21 patients enrolled in phase I, 2 patients developed dose-limiting toxicities (DLTs): 1 grade 3 esophagitis with dysphagia (at 40 mg) and 1 grade 3 esophagitis with dehydration (at 80 mg). No DLTs were seen at veliparib dose of 120 mg twice daily, which was selected for the phase II part that enrolled 31 eligible patients. Progression-free survival (PFS) was not different between the 2 arms (P = .20). For the veliparib and placebo arms, response rates were 56% and 69%, PFS at 1 year 47% and 46%, and overall survival at 1 year 89% and 54%, respectively.ConclusionVeliparib with CRT was feasible and well tolerated. Efficacy could not accurately be determined because of early study closure. Nonetheless, there is enthusiasm for the evaluation of PARP inhibitors in lung cancer as predictive biomarkers are being developed and combinations with immunotherapy are attractive.

Published
2021

3. Early-Stage Primary Lung Neuroendocrine Tumors Treated With Stereotactic Body Radiation Therapy: A Multi-Institution Experience

Author

Oliver, Daniel E., Laborde, Jose M., Singh, Deepinder P., Milano, Michael T., Videtic, Gregory M., Williams, Graeme R., LaRiviere, Michael J., Chan, Jason W., Peters, Gabrielle W., Decker, Roy H., Samson, Pamela, Robinson, Clifford G., Breen, William G., Owen, Dawn, Tian, Sibo, Higgins, Kristin A., Almeldin, Doaa, Jabbour, Salma K., Wang, Fen, Grass, G. Daniel, Perez, Bradford A., Dilling, Thomas J., Strosberg, Jonathan, and Rosenberg, Stephen A.

Published
2023
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7. Update on International Cooperative Groups Studies in Thoracic Malignancies: The Emergence of Immunotherapy.

Author

Shukla, Navika D, Salahudeen, Ameen A, Taylor, Gregory A, Ramalingam, Suresh S, Vokes, Everett E, Goss, Glenwood D, Decker, Roy H, Kelly, Karen, Scagliotti, Giorgio V, Mok, Tony S, and Wakelee, Heather A

Subjects
Humans, Thoracic Neoplasms, Prognosis, Immunotherapy, International Cooperation, Clinical Trials as Topic, Clinical trials, Mesothelioma, Non–small-cell lung cancer, Small cell lung cancer, Thymic carcinoma, Non-small-cell lung cancer, Lung, Lung Cancer, Cancer, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

Cancer cooperative groups have historically played a critical role in the advancement of non-small-cell lung cancer therapy. Representatives from cooperative groups worldwide convene at the International Lung Cancer Congress annually. The International Lung Cancer Congress had its 17th anniversary in the summer of 2016. The present review highlights the thoracic malignancy studies discussed by presenters. The included studies are merely a sample of the trials of thoracic malignancies ongoing globally.

Published
2018

8. Lung Cancer and Other Thoracic Malignancies

Author

Harkenrider, Matthew M., Silva, Scott R., Decker, Roy H., Kauczor, Hans-Ulrich, Series Editor, Parizel, Paul M., Series Editor, Peh, Wilfred C. G., Series Editor, Brady, Luther W, Series Editor, Lu, Jiade J., Series Editor, Lo, Simon S., editor, Teh, Bin S., editor, Jiang, Guo-Liang, editor, and Mayr, Nina A., editor

Published
2020
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19. Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (≥5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis

Author

Verma, Vivek, Shostrom, Valerie K., Zhen, Weining, Zhang, Mutian, Braunstein, Steve E., Holland, John, Hallemeier, Christopher L., Harkenrider, Matthew M., Iskhanian, Adrian, Jabbour, Salma K., Attia, Albert, Lee, Percy, Wang, Kyle, Decker, Roy H., McGarry, Ronald C., and Simone, Charles B., II

Published
2017
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22. Multi-Institutional Experience of Stereotactic Ablative Radiation Therapy for Stage I Small Cell Lung Cancer

Author

Verma, Vivek, Simone, Charles B., II, Allen, Pamela K., Gajjar, Sameer R., Shah, Chirag, Zhen, Weining, Harkenrider, Matthew M., Hallemeier, Christopher L., Jabbour, Salma K., Matthiesen, Chance L., Braunstein, Steve E., Lee, Percy, Dilling, Thomas J., Allen, Bryan G., Nichols, Elizabeth M., Attia, Albert, Zeng, Jing, Biswas, Tithi, Paximadis, Peter, Wang, Fen, Walker, Joshua M., Stahl, John M., Daly, Megan E., Decker, Roy H., Hales, Russell K., Willers, Henning, Videtic, Gregory M.M., Mehta, Minesh P., and Lin, Steven H.

Published
2017
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25. Prediction of Distant Metastases After Stereotactic Body Radiation Therapy for Early Stage NSCLC Development and External Validation of a Multi-Institutional Model: development and external validation of a multi-institutional model

Author

Gao, Sarah, Jin, Lan, Meadows, Hugh W, Shafman, Timothy, Gross, Cary P, Yu, James B, Aerts, Hugo Jwl, Miccio, Joseph A, Stahl, John M, Mak, Raymond H, Decker, Roy H, Kann, Benjamin H, Gao, Sarah, Jin, Lan, Meadows, Hugh W, Shafman, Timothy, Gross, Cary P, Yu, James B, Aerts, Hugo Jwl, Miccio, Joseph A, Stahl, John M, Mak, Raymond H, Decker, Roy H, and Kann, Benjamin H

Abstract

OBJECTIVES: Distant metastases (DM) are the primary driver of mortality for patients with early stage non-small cell lung cancer (NSCLC) receiving stereotactic body radiation therapy (SBRT), yet patient-level risk is difficult to predict. We developed and validated a model to predict individualized risk of DM in this population.METHODS: We utilized a multi-institutional database of 1,280 patients with cT1-3N0M0 NSCLC treated with SBRT from 2006-2015 for model development and internal validation. A Fine and Gray (FG) regression model was built to predict 1-year DM risk and compared to a random survival forests (RSF) model. The higher performing model was evaluated on an external dataset of 130 patients from a separate institution. Discriminatory performance was evaluated using the time-dependent area under the curve (AUC). Calibration was assessed graphically and with Brier scores.RESULTS: The FG model yielded an AUC of 0.71 (95% CI: 0.57-0.86) compared to the RSF's AUC of 0.69 [95% CI: 0.63-0.85] in the internal test set and was selected for further testing. On external validation, the FG model yielded an AUC 0.70 (95% CI: 0.57-0.83) with good calibration (Brier score 0.08). The model identified a high-risk patient subgroup with greater 1-year DM rates in the internal test (20.0% (3/15) v 2.9% (7/241), P=0.001) and external validation 21.4% (3/15) v 7.8% (9/116), P= 0.095). A model nomogram and online application was made available.CONCLUSIONS: We developed and externally validated a practical model that predicts DM risk in NSCLC patients receiving SBRT that may help select patients for systemic therapy.

Published
2023

31. Skin Surface, Dermis, and Wound Healing

Author

Decker, Roy H., Strom, Eric A., Wilson, Lynn D., Brady, Luther W., Series editor, Molls, Michael, Series editor, Heilmann, Hans-Peter, Series editor, Nieder, Carsten, Series editor, Rubin, Philip, editor, Constine, Louis S., editor, and Marks, Lawrence B., editor

Published
2014
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32. A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 1: a guide to decision-making

Author

Detterbeck, Frank C., Blasberg, Justin D., Woodard, Gavitt A., Decker, Roy H., Kumbasar, Ulas, Park, Henry S., Mase, Vincent J., Bade, Brett C., Li, Andrew X., Brandt, Whitney S., and Madoff, David C.

Subjects
Pulmonary and Respiratory Medicine, Review Article on A Guide for Managing Patients with Stage I NSCLC: Deciding between Lobectomy, Segmentectomy, Wedge, SBRT and Ablation
Abstract

BACKGROUND: Clinical decision-making for patients with stage I lung cancer is complex. It involves multiple options (lobectomy, segmentectomy, wedge, Stereotactic Body Radiotherapy, thermal ablation), weighing multiple outcomes (e.g., short-, intermediate-, long-term) and multiple aspects of each (e.g., magnitude of a difference, the degree of confidence in the evidence, and the applicability to the patient and setting at hand). A structure is needed to summarize the relevant evidence for an individual patient and to identify which outcomes have the greatest impact on the decision-making. METHODS: Based on a systematic review from 2000–2021, evidence regarding relevant outcomes was assembled, with attention to aspects of applicability, uncertainty and effect modifiers. A framework was developed to present this information a format that enhances decision-making at the point of care for individual patients. RESULTS: While patients often cross over several boundaries, the evidence fits into categories of healthy patients, compromised patients, and favorable tumors. In healthy patients with typical (i.e., solid spiculated) lung cancers, the impact on long-term outcomes is the major driver of treatment selection. This is only slightly ameliorated in older patients. In compromised patients increasing frailty accentuates short-term differences and diminishes long-term differences especially when considering non-surgical vs. surgical approaches; nuances of patient selection (technical treatment feasibility, anticipated risk of acute toxicity, delayed toxicity, and long-term outcomes) as well as patient values are increasingly influential. Favorable (less-aggressive) tumors generally have good long-term outcomes regardless of the treatment approach. DISCUSSION: A framework is provided that organizes the evidence and identifies the major drivers of decision-making for an individual patient. This facilitates blending available evidence and clinical judgment in a flexible, nuanced manner that enhances individualized clinical care.

Published
2022
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33. A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 4: systematic review of evidence involving SBRT and ablation

Author

Park, Henry S., Detterbeck, Frank C., Madoff, David C., Bade, Brett C., Kumbasar, Ulas, Mase, Vincent J., Li, Andrew X., Blasberg, Justin D., Woodard, Gavitt A., Brandt, Whitney S., and Decker, Roy H.

Subjects
Pulmonary and Respiratory Medicine, Review Article on A Guide for Managing Patients with Stage I NSCLC: Deciding between Lobectomy, Segmentectomy, Wedge, SBRT and Ablation
Abstract

BACKGROUND: Clinical decision-making for patients with stage I lung cancer is complex. It involves multiple options [lobectomy, segmentectomy, wedge, stereotactic body radiotherapy (SBRT), thermal ablation], weighing multiple outcomes (e.g., short-, intermediate-, long-term) and multiple aspects of each (e.g., magnitude of a difference, the degree of confidence in the evidence, and the applicability to the patient and setting at hand). A structure is needed to summarize the relevant evidence for an individual patient and to identify which outcomes have the greatest impact on the decision-making. METHODS: A PubMed systematic review from 2000–2021 of outcomes after SBRT or thermal ablation vs. resection is the focus of this paper. Evidence was abstracted from randomized trials and non-randomized comparisons with at least some adjustment for confounders. The analysis involved careful assessment, including characteristics of patients, settings, residual confounding etc. to expose degrees of uncertainty and applicability to individual patients. Evidence is summarized that provides an at-a-glance overall impression as well as the ability to delve into layers of details of the patients, settings and treatments involved. RESULTS: Short-term outcomes are meaningfully better after SBRT than resection. SBRT doesn’t affect quality-of-life (QOL), on average pulmonary function is not altered, but a minority of patients may experience gradual late toxicity. Adjusted non-randomized comparisons demonstrate a clinically relevant detriment in long-term outcomes after SBRT vs. surgery. The short-term benefits of SBRT over surgery are accentuated with increasing age and compromised patients, but the long-term detriment remains. Ablation is associated with a higher rate of complications than SBRT, but there is little intermediate-term impact on quality-of-life or pulmonary function tests. Adjusted comparisons show a meaningful detriment in long-term outcomes after ablation vs. surgery; there is less difference between ablation and SBRT. CONCLUSIONS: A systematic, comprehensive summary of evidence regarding Stereotactic Body Radiotherapy or thermal ablation vs. resection with attention to aspects of applicability, uncertainty and effect modifiers provides a foundation for a framework for individualized decision-making.

Published
2022
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34. A guide for managing patients with stage I NSCLC: deciding between lobectomy, segmentectomy, wedge, SBRT and ablation—part 3: systematic review of evidence regarding surgery in compromised patients or specific tumors

Author

Bade, Brett C., Blasberg, Justin D., Mase, Vincent J., Kumbasar, Ulas, Li, Andrew X., Park, Henry S., Decker, Roy H., Madoff, David C., Brandt, Whitney S., Woodard, Gavitt A., and Detterbeck, Frank C.

Subjects
Pulmonary and Respiratory Medicine, Review Article on A Guide for Managing Patients with Stage I NSCLC: Deciding between Lobectomy, Segmentectomy, Wedge, SBRT and Ablation
Abstract

BACKGROUND: Clinical decision-making for patients with stage I lung cancer is complex. It involves multiple options [lobectomy, segmentectomy, wedge, stereotactic body radiotherapy (SBRT), thermal ablation], weighing multiple outcomes (e.g., short-, intermediate-, long-term) and multiple aspects of each (e.g., magnitude of a difference, the degree of confidence in the evidence, and the applicability to the patient and setting at hand). A structure is needed to summarize the relevant evidence for an individual patient and to identify which outcomes have the greatest impact on the decision-making. METHODS: A PubMed systematic review from 2000–2021 of outcomes after lobectomy, segmentectomy and wedge resection in older patients, patients with limited pulmonary reserve and favorable tumors is the focus of this paper. Evidence was abstracted from randomized trials and non-randomized comparisons (NRCs) with adjustment for confounders. The analysis involved careful assessment, including characteristics of patients, settings, residual confounding etc. to expose degrees of uncertainty and applicability to individual patients. Evidence is summarized that provides an at-a-glance overall impression as well as the ability to delve into layers of details of the patients, settings and treatments involved. RESULTS: In older patients, perioperative mortality is minimally altered by resection extent and only slightly affected by increasing age; sublobar resection may slightly decrease morbidity. Long-term outcomes are worse after lesser resection; the difference is slightly attenuated with increasing age. Reported short-term outcomes are quite acceptable in (selected) patients with severely limited pulmonary reserve, not clearly altered by resection extent but substantially improved by a minimally invasive approach. Quality-of-life (QOL) and impact on pulmonary function hasn’t been well studied, but there appears to be little difference by resection extent in older or compromised patients. Patient selection is paramount but not well defined. Ground-glass and screen-detected tumors exhibit favorable long-term outcomes regardless of resection extent; however solid tumors

Published
2022
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35. List of Contributors

Author

Arenberg, Douglas, primary, Arnold, Brian N., additional, Bade, Brett C., additional, Baldassarri, Stephen R., additional, Blasberg, Justin D., additional, Bledsoe, Trevor J., additional, Boffa, Daniel J., additional, Chiang, Anne, additional, Chilakamarry, Sitaram, additional, Decker, Roy H., additional, Fucito, Lisa M., additional, Gould, Michael K., additional, Herbst, Roy S., additional, Kim, Anthony W., additional, Kim, Clara, additional, Korst, Robert J., additional, Mazzone, Peter, additional, Nair, Viswam S., additional, Nathani, Niket, additional, Nath, Sameer K., additional, Osarogiagbon, Raymond U., additional, Possick, Jennifer D., additional, Rivera, M. Patricia, additional, Shapiro, Mark, additional, Silvestri, Gerard A., additional, Talsania, Ashita, additional, Tanner, Nichole T., additional, and Xia, Bing, additional

Published
2018
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37. Table S3 from Early Assessment of Lung Cancer Immunotherapy Response via Circulating Tumor DNA

Author

Goldberg, Sarah B., primary, Narayan, Azeet, primary, Kole, Adam J., primary, Decker, Roy H., primary, Teysir, Jimmitti, primary, Carriero, Nicholas J., primary, Lee, Angela, primary, Nemati, Roxanne, primary, Nath, Sameer K., primary, Mane, Shrikant M., primary, Deng, Yanhong, primary, Sukumar, Nitin, primary, Zelterman, Daniel, primary, Boffa, Daniel J., primary, Politi, Katerina, primary, Gettinger, Scott N., primary, Wilson, Lynn D., primary, Herbst, Roy S., primary, and Patel, Abhijit A., primary

Published
2023
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38. Supplementary Methods, Figures S1-6, Tables S1,2,4,6-8 from Early Assessment of Lung Cancer Immunotherapy Response via Circulating Tumor DNA

Author

Goldberg, Sarah B., primary, Narayan, Azeet, primary, Kole, Adam J., primary, Decker, Roy H., primary, Teysir, Jimmitti, primary, Carriero, Nicholas J., primary, Lee, Angela, primary, Nemati, Roxanne, primary, Nath, Sameer K., primary, Mane, Shrikant M., primary, Deng, Yanhong, primary, Sukumar, Nitin, primary, Zelterman, Daniel, primary, Boffa, Daniel J., primary, Politi, Katerina, primary, Gettinger, Scott N., primary, Wilson, Lynn D., primary, Herbst, Roy S., primary, and Patel, Abhijit A., primary

Published
2023
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40. Supplementary Methods, Figure Legends 1-2, Tables 1-4 from Ultrasensitive Measurement of Hotspot Mutations in Tumor DNA in Blood Using Error-Suppressed Multiplexed Deep Sequencing

Author

Narayan, Azeet, primary, Carriero, Nicholas J., primary, Gettinger, Scott N., primary, Kluytenaar, Jeannie, primary, Kozak, Kevin R., primary, Yock, Torunn I., primary, Muscato, Nicole E., primary, Ugarelli, Pedro, primary, Decker, Roy H., primary, and Patel, Abhijit A., primary

Published
2023
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47. Angiotensin receptor blockade: a novel approach for symptomatic radiation necrosis after stereotactic radiosurgery

Author

Chowdhary, Mudit, Okwan-Duodu, Derick, Switchenko, Jeffrey M., Press, Robert H., Jhaveri, Jaymin, Buchwald, Zachary S., Zhong, Jim, Chapman, Bhavana V., Bindra, Ranjit S., Contessa, Joseph N., Park, Henry S., Yu, James B., Decker, Roy H., Olson, Jeffrey J., Oyesiku, Nelson M., Abrams, Ross A., Shu, Hui-Kuo G., Curran, Jr., Walter J., Crocker, Ian R., and Patel, Kirtesh R.

Published
2017
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49. Harnessing the Immunomodulatory Effects of Radiation Therapy

Author

Campbell, Allison M. and Decker, Roy H.

Subjects
Cell death -- Health aspects, Radiotherapy -- Patient outcomes, Cellular signal transduction -- Health aspects, Immune response regulation -- Physiological aspects, Dose-response relationship, DNA damage, Cancer genetics, Cancer, Antigens, Immunotherapy, Tumors, Immune response, Immune system, Inflammation, Radiation (Physics), DNA, Biochemistry, Health
Abstract

In this article, we discuss the immunogenicity of radiation-induced cell death and describe the innate immune signaling pathways that precede adaptive antitumoral immunity. The innate and adaptive immune systems work in concert to generate systemic immune responses. In the setting of cancer, DNA damage caused by radiotherapy activates the innate immune system while tumor cell death liberates antigen that serves as a target for adaptive immunity. The immunomodulatory effects of radiation have been investigated in preclinical models; here we summarize the available data, with particular attention to the effects of radiotherapy timing, location, dose, and fractionation strategy on the antitumoral immune response. We synthesize preclinical and clinical information regarding the potential superiority of hypofractionated radiation for induction of proinflammatory responses. Although many questions remain, early successes with combining immunotherapy and radiotherapy merit further inquiry into the dose and fractionation strategies best able to activate and sustain an antitumoral response., IntroductionSince x-rays were first used to treat cancer in the 1890s, [1] the field of radiation oncology has evolved clinically toward dose and fractionation strategies that maximize tumor control while [...]

Published
2018

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